Anyone who has sat in the outer office waiting for an appointment with their doctor may have noticed the number of pharmaceutical sales representatives who show up there nowadays. Some physicians have a special "holding room" where these folks cool their heels waiting for their turn to offer free samples and other inducements to push their particular products.
And it seems the nightly network news shows couldn't survive without the advertising dollars spent by the drug companies to promote their latest cures -- or as the newscasters often proclaim -- another "medical breakthrough."
West Virginia's state government is a big customer of prescription drugs, not only for public employees but also those who depend on the state Medicaid program and other programs for assistance with prescription drugs. According to one state official, West Virginia spent more than $400 million in 2007 alone.
So the Legislature created the state Pharmaceutical Cost Management Council in an effort to keep state spending on prescription drugs at a manageable level. Ironically, two legislative champions of this effort are Delegate Don Perdue, D-Wayne, who is a pharmacist, and Sen. Dan Foster, D-Kanawha, who is a physician.
One of the steps is to require periodic reports of how much money the pharmaceutical companies spend in West Virginia to encourage doctors to prescribe and patients to ask for the more expensive, brand-name prescription drugs. Last week, the first report for the last six months of 2007 was made public by the Council. And it proved to be just the tip of the iceberg.
The bottom line?
Spending disclosure forms filed by no less than 111 pharmaceutical manufacturers listed 14,933 separate "gifts, grants or payments" to state physicians during those six months. The amounts range from $50 to $52,000 each. And it's evident some physicians are taking multiple payments since the number of payments listed far exceeds the number of doctors now practicing in the state.
But like the political candidates' forms where the politician simply indicates a personal asset has a value of somewhere between $10,000 and $100,000, this report on the drug companies is short on detail. It does not include the names of any doctor.
But even Gov. Joe Manchin, who did his part to help block tougher financial disclosure requirements at the 2007 legislative session, has decided more information is needed to make these reports meaningful. Shana Phares, the acting state Pharmaceutical Advocate, said the governor has ordered her to come up with some suggested options that will provide more details in future reports.
Since both Perdue and Foster have long been identified with much stronger disclosure requirements, both are now cautiously optimistic that the administration's support will be solid enough to put some teeth in the disclosure process during the 2009 legislative session that begins in February.
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Meanwhile, the West Virginia economy has long been immune to dramatic swings at the national level. So it is not so surprising that the 2007-2008 tax collections in the Mountain State were a record $3.9 billion, an increase of 4.7 percent over the previous budget year,
And the Rockefeller Institute of Government has released a report that indicates West Virginia is one of only four states with increased tax collections of more than 10 percent during the January-March quarter of 2008 compared to a year ago.
Severance tax collections in West Virginia made the difference as coal prices climbed from $45 a ton to more than $100 a ton. The severance tax is 5 percent of that price. But collections of the state's consumer sales tax -- 6 percent on most items and now 3 percent on food -- produced $47.5 million less than expected.
And with state receipts from the lottery commission which includes new table games at three of the state's four racetracks dropping for the first time in 20 years, balancing the 2009-2010 state budget may be more of a challenge than usual.
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Finally, it's been noted recently that about one third of the estimated 260,000 senior citizens in West Virginia can't afford to retire but are ill-equipped to find suitable employment that will help them. Experts believe there are 99,000 people who are 55 or older and have income of no more than 125 percent of the federal poverty level.
Government's response is a program that pays them minimum wage to work up to 20 hours a week while they are trained. The problem is that so many of them can't fill slots in the state's biggest industries and just as many live in rural areas where transportation to the workplace is a major obstacle.
Tom Miller is a retired state government reporter for The Herald-Dispatch and a regular contributor to the editorial page.
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